TY - JOUR
T1 - Airway eosinophilia in remission and progression of asthma
T2 - Accumulation with a fast decline of FEV1
AU - Broekema, M.
AU - Volbeda, F.
AU - Timens, W.
AU - Dijkstra, A.
AU - Lee, N. A.
AU - Lee, J. J.
AU - Lodewijk, M. E.
AU - Postma, D. S.
AU - Hylkema, M. N.
AU - Ten Hacken, N. H.T.
PY - 2010/9/1
Y1 - 2010/9/1
N2 - Background: As it is unknown whether complete asthma remission or progression of asthma is associated with airway inflammation and remodeling, we assessed these characteristics in bronchial biopsies of relevant subsets of asthma patients. Methods: Sputum and bronchial biopsies were obtained from asthma patients in remission (PC20 histamine > 32 mg/ml, PC 20 AMP > 320 mg/ml) and from those with either a slow FEV 1 decline (<30 ml/year) or fast decline (>30 ml/year). Inflammatory cells and mediators were determined in sputum, inflammatory cells and aspects of airway remodeling in bronchial biopsies. Results: Asthmatics in remission and asthma patients with a slow FEV1 decline had a similar extent of airway inflammation and remodeling in sputum and bronchial biopsies. Asthma patients with a fast FEV1 decline had high sputum eosinophil numbers. Moreover, FEV1 decline (ml/year) correlated with sputum eosinophil numbers (Rs = 0.51, p = 0.003) and ECP levels (Rs = 0.57, p = 0.001). Airway remodeling, i.e. basement membrane thickness, correlated with sputum eosinophils (Rs = 0.69, p < 0.001), sputum ECP (Rs = 0.46, p = 0.018) and airway wall eosinophil numbers (Rs = 0.49, p = 0.002). Conclusions: Asthma, even when in remission, is accompanied by airway inflammation and remodeling. Data suggest that eosinophils are important in a subset of asthma patients by association to accelerated FEV1 decline and change of basement membrane thickness.
AB - Background: As it is unknown whether complete asthma remission or progression of asthma is associated with airway inflammation and remodeling, we assessed these characteristics in bronchial biopsies of relevant subsets of asthma patients. Methods: Sputum and bronchial biopsies were obtained from asthma patients in remission (PC20 histamine > 32 mg/ml, PC 20 AMP > 320 mg/ml) and from those with either a slow FEV 1 decline (<30 ml/year) or fast decline (>30 ml/year). Inflammatory cells and mediators were determined in sputum, inflammatory cells and aspects of airway remodeling in bronchial biopsies. Results: Asthmatics in remission and asthma patients with a slow FEV1 decline had a similar extent of airway inflammation and remodeling in sputum and bronchial biopsies. Asthma patients with a fast FEV1 decline had high sputum eosinophil numbers. Moreover, FEV1 decline (ml/year) correlated with sputum eosinophil numbers (Rs = 0.51, p = 0.003) and ECP levels (Rs = 0.57, p = 0.001). Airway remodeling, i.e. basement membrane thickness, correlated with sputum eosinophils (Rs = 0.69, p < 0.001), sputum ECP (Rs = 0.46, p = 0.018) and airway wall eosinophil numbers (Rs = 0.49, p = 0.002). Conclusions: Asthma, even when in remission, is accompanied by airway inflammation and remodeling. Data suggest that eosinophils are important in a subset of asthma patients by association to accelerated FEV1 decline and change of basement membrane thickness.
KW - Airway inflammation
KW - Airway remodeling
KW - Eosinophils
KW - Lung function decline
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U2 - 10.1016/j.rmed.2010.03.030
DO - 10.1016/j.rmed.2010.03.030
M3 - Article
C2 - 20434897
AN - SCOPUS:77955659342
VL - 104
SP - 1254
EP - 1262
JO - Respiratory Medicine
JF - Respiratory Medicine
SN - 0954-6111
IS - 9
ER -